This invention is an improved unit having cardiotomy reservoir capabilities as well as pleural drainage and autotransfusion capabilities with a vacuum regulation and seal system. It incorporates features pertaining to a quick disconnect for changing the functions of the combined unit hereof. When referring to autotransfusion it should be understood that pleural drainage is incorporated in such activity. Thus, the term pleural drainage/autotransfusion shall refer to when the device or function incorporates pleural drainage by itself or when used with autotransfusion.
Cardiotomy reservoirs have been known in the prior art. Such cardiotomy reservoirs are utilized to retain (store) fluids during open heart surgery from the chest cavity. When fluids are removed from the chest cavity, they are suctioned into the cardiotomy reservoir. Such cardiotomy reservoirs can maintain the fluid in situ therein or filter it. Oftentimes, filtration depending upon the surgical procedure, is a preferred combined function for the cardiotomy reservoir.
Such filtering can remove clots and extraneous material from the blood so that the blood can be returned to the patient. During the passage of the fluid to the patient, it can be through an oxygenator. Oxygenators are well known in the prior art for oxygenating blood in a continuous cycle. Such oxygenators provide the function of the lungs during open heart surgery, so that the blood can be utilized by the body.
The cardiotomy reservoirs of the prior art have also been known to have the filtration system as an option or in some cases been eliminated. In these instances, the blood as passed through the patient is of sufficient purity so as to not require filtering. In some cases a separate filter can be used or an oxygenator can be used to avoid the use of filtration. Be that as it may, the cardiotomy reservoirs are currently an important and helpful adjunct to all apparatus during open-heart surgery.
An innovation of recent note has been the re-introduction of systems for providing autotransfusion. Autotransfusion is the transfusion of the blood lost by a patient back to the patient. Autotransfusion was known as early as the 19th century as the method of recovering a patient's blood. Also, there are known uses of autotransfusion in the literature as early as 1924 on a sophisticated and well thought-out basis. With the advent of blood banks, autotransfusion was not deemed as necessary. The preferred method during a substantial portion of this century was to utilize banked blood.
Such banked blood, although helpful in operations, is not preferable when considering the physiological benefits of utilizing the patient's own blood. Not only does the patient's blood have compatibility when handled properly, but it can be of superior quality to banked blood. This being the case, many surgeons are utilizing techniques of autotransfusion to enhance a patient's overall health during operations.
Autotransfusion techniques are such wherein they rely upon the removal of blood and fluids from a patient's body. The blood is then returned through the autotransfusion unit.
A substantial example of usage is within the open-heart surgical area. Such open-heart surgical usage usually relies upon the withdrawal of fluids from a patient's chest cavity. The withdrawal of fluids is to not only drain the chest cavity of any blood loss, but also other fluids which are drained out of a patient's chest post operatively. Such fluids during autotransfusion are drawn into the autotransfusion unit under vacuum and gravity drain. The source of vacuum has generally been provided by a hospital fixed vacuum system. The vacuum system can incorporate a regulator for purposes of maintaining approximately 20 CM. H.sub.2 O vacuum. The 20 CM. H.sub.2 O vacuum allows chest drainage to continue on a basis which is not detrimental yet at the same time maintains sufficient draw to pull fluids into the autotransfusion unit and maintain negative pressure in the patient's pleural space.
There is a significant drawback in converting a device, such as the cardiotomy, from intraoperative use to post operative use. The removal of tubing from the barbed connectors, by design, is difficult at best. Ordinarily, the tubing is left on the connectors when the device is discarded in the operating room.
However, in this situation where the device is not discarded, certain tubing will have to be removed from certain barbed connectors. This removal typically requires cutting of the tubing at the connector, thereby increasing the risk of violating the sealing feature of the barbs, and/or personal injury. This is also difficult to accomplish while maintaining aseptic technique.
The significance of having quick disconnects is therefore known by those skilled in the art.
The invention is changed from a cardiotomy reservoir to an autotransfusion unit by disconnecting the PVC tubing lines used during surgery by means of the quick disconnectors. A chest drainage tube inserted into the patient's chest provides a chest drainage function. The chest drainage tube allows the autotransfusion unit to then flow fluid through a reservoir outlet connector to a volumetric infusion pump. It is transported with the patient as the patient is taken from the operating room. The volumetric infusion pump is in turn connected to a line to the patient for intravenous flow into the patient.
The invention specifically operates in the advantageous manner of not requiring a separate manometer or low vacuum regulator extrinsic to the unit. The invention merely requires a line to be extended from the normal hospital fixed vacuum system to the unit without the interface of a separate manometer or flow control device.
The cardiotomy autotransfusion/pleural drainage reservoir eliminates the need for dedicated pleural drainage devices as well as the requirement for a separate water manometer. It reduces the need for homologous blood and blood products while supporting the patient's hemodynamic stability without the intrusion of various interfacing components. One component alone, namely the unit of this invention, need be used.
The action of the invention helps to conserve the blood of the patient as well as minimize the risk of transfusion related infections and serves to return the patient's plasma and electrolytes.
The invention hereof is also extremely time efficient. This is a critical element during operations. As can be appreciated, the less time in any operation that is utilized, the less exposure the patient has to problems, particularly during open-heart surgery.
The invention also provides for respective bypass capability and numerous optional features with respect to the various inlets and overall relationship which it enjoys. This is in conjunction with its utilization both during the surgery and post-operatively. This in fact is accomplished through the ease of its hookup and utilization on a patient's bed without extra equipment such as manometers, and related support equipment.